Johnson's Diagnosogenic Theory of Stuttering: An Update. (Refereed Paper)

Article excerpt

SPEECH THERAPY TODAY has suffered because many speech-language pathologists misunderstand Wendell Johnson's teachings on "stuttering." They believe that Johnson taught that assigning the label stuttering to a speaker's repetitions of sounds and syllables and other hesitancies actually caused the disorder. They could not be more mistaken.

Johnson examined how human responses to an event can reinforce it; he did not specify labeling as a cause. As a general semanticist, Johnson hated such word magic (the belief that we can speak things into existence); for correct evaluation, the event or thing had to precede the word.

Johnson faced a world that believed what many people believe today, that stuttering is a speech disease. Popular wisdom says that everybody can recognize the symptoms, because all repetitions of sounds or syllables that occur frequently in a child's speech are "stuttering" and these indicate that the child has the disease as certainly as the presence of blisters indicate the presence of chicken pox.

What Johnson Believed

In contrast with the popular superstitions of his day, Johnson believed that instrumental conditioning caused problematic "stuttering."

Parental responses to their children's early speech efforts were mediated by their "diagnoses" of this speech as the disorder "stuttering," and this led to chronic "stuttering." (1) It was not the word stuttering that caused "stuttering": it was reactions to the word that created the undesirable reinforcement of stuttering. While Johnson may not have discovered why all children begin to "stutter," he certainly understood how stuttering, whether "organic" or normal, becomes chronic. (2)

One of today's most widely used speech pathology texts (Guitar, 1998) reports that around 80% of all children who begin stuttering overcome it spontaneously. Guitar asserts that only those children who fail to adjust to what he calls "core stuttering" (repetitions of sounds and syllables) go on to become chronic stutterers. This suggests that chronic stutterers were taught (by themselves or others) to become frightened, ashamed, and guilt ridden when they stuttered and as a result attempted to avoid these feelings by avoiding stuttering, creating the vicious cycle called "stuttering." Stuttering, as Johnson maintained, became an "anticipatory, apprehensive, hypertonic avoidance reaction."

When persons behave in this way, they have "maladjusted" to their stuttering. However, if they do not fear their stuttering, if they accept it, do not anticipate it, do not try to avoid it (and therefore create it), they have "adjusted" to it.

The anticipation of making a series of repeated sounds that stutterers experience as stuttering does not always involve a specific word. It can be a feeling of anxiety associated with certain speaking situations. Stutterers cannot always predict the specific words on which they will stutter; however, a generalized feeling of fearful expectancy exists.

Many experts today attribute chronic stuttering to speakers' efforts to avoid painful emotions created by their evaluations of stuttering: fear of guilt, fear of shame, fear of fear, etc. Attempts to avoid these feelings result in efforts to avoid stuttering, and these efforts, along with repetitions of sounds and syllables and prolongations of sounds, appear as stuttering. The British call these reactions stammering and evidently regard the repetition of sounds or syllables as just one symptom of the disorder. This seems like a useful approach to me.

The Map is Not the Territory

Some young children who begin to repeat sounds and syllables at the beginning of words will adjust to this by making it a non-issue and disregarding it or by considering it normal, not shameful, disgusting, or wrong. Most importantly, they never become self-doubters because of it.

Johnson taught that false belief causes irrational conduct. …